Life After Breast Cancer: What No One Tells You

Sudden Swelling

Lymphedema, which most commonly develops within 18 to 24 months of treatment, affects between 35 and 40 percent of women who have had any number of lymph nodes removed or radiation to their underarm area. This damages the remaining nodes, compromising the body's ability to drain excess fluids and protein from the soft tissues of the arm, explains Saskia Thiadens, executive director of the National Lymphedema Network, inOakland, California. As a result, lymph fluid builds up, causing pain, heat, tightness, swelling, and hard, stiff skin.

Even an insect bite or minor cut on the affected arm can lead to a serious infection that may require emergency medical attention, says Ting-Ting Kuo, a physical therapist and clinical specialist for the women's health program at the Rusk Institute for Rehabilitation Medicine atNew York University Medical Center, in New York City. Travel by plane may aggravate lymphedema, and some women can no longer fit into their clothes or pick up their children.

What helps: Even though lymphedema is a lifelong condition, most women are able to manage it successfully with a combination of physical therapy, massage, bandaging, and compression. Richards now wears a compression sleeve that extends from her knuckles to her shoulder when exercising or doing any repetitive movements, such as gardening.           

What's more, a new surgical procedure, called sentinel lymph node dissection, may help reduce lymphedema risk, Dr. Ganz says. It's used to determine if cancer has spread and reduces the number of nodes removed from more than 10 to just one or two.